Middle East Respiratory Syndrome (MERS)

1. Definition

Respiratory infections caused by Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

* In May 13, the International Committee on Taxonomy of Viruses (ICTV) named this new coronavirus MERS-CoV.

2. Symptoms / Complications

Most patients have severe acute pneumonitis (pneumonia), but some are asymptomatic or mild acute upper respiratory disease.

The main symptoms are fever, cough and shortness of breath.
Others include headaches, chills, sore throat, runny nose and muscle aches as well as anorexia, nausea, vomiting, abdominal pain and diarrhea.

Representative complications include respiratory failure, pulmonary shock, and multiple organ failures, and acute renal failure is more common than SARS. People with underlying diseases (diabetes, chronic lung disease, cancer, kidney failure, etc.) and those with reduced immune function have a high MERS-CoV infection and a poor prognosis.

Common laboratory findings are leukopenia, lymphopenia, thrombocytopenia, and elevated LDH.

The incubation period is five days (minimum two days-maximum fourteen days), and fatality rates range from 30% to 40%, according to reports in Saudi Arabia.

3. Epidemiological Characteristics

The age distribution of patients ranges from 0 to 99 (median 50). Severe acute respiratory illnesses are common, especially in people with underlying diseases (diabetes, kidney failure, chronic lung disease, immunodeficiency diseases). Almost all patients are directly or indirectly associated with the Middle East, and over 90% of them are related to Saudi Arabia. The grounds for dissemination in the community have not yet been established and are prevalent mainly due to family dissemination and limited dissemination in medical institutions. The symptoms of secondary infections are relatively minor than those of primary infections.